COGNITIVE-BEHAVIORAL THERAPY FOR BDD: NEEDED THERAPY RESEARCH

CBT is clearly a very promising treatment for BDD. Nonetheless, we need much more research on this treatment! Most important, a CBT treatment manual needs to be developed to guide therapists as they provide CBT. Once a manual is developed and tested, we need more rigorous studies of CBT’s effectiveness using the manual. Studies need to compare CBT to other treatments, such as other types of therapy and SRIs.

Research is also needed to determine the optimal session length and number of therapy sessions (although these may vary somewhat for different people). Future studies need to include broader samples of patients (e.g., men as well as women, members of minority groups, people with delusional BDD, and a range of BDD severity). A broader range of outcomes needs to be assessed—not only improvement in BDD but also in body image, functioning, and quality of life.

There are many other unanswered questions about CBT that research is needed to answer. Is individual therapy better than group therapy—or vice versa? Each may have its advantages. For example, group therapy enables people to meet others with BDD and involves a lot of exposure (sitting in a room with other people), whereas individual treatment can be better tailored to the individual person. Does CBT help protect against relapse in people who discontinue an effective SRI? Until studies of this important question are done, it shouldn’t be assumed that if you have CBT you’ll do fine if you stop an SRI, although it’s possible that CBT will diminish the risk of relapse. It also needs to be determined whether adding an SRI to partially effective or ineffective CBT makes people even better; clinical experience suggest that it often does. We also need to study for whom CBT works best. In addition CBT needs to be adapted for use in adolescents, since this is the age when BDD usually develops.

Even though we need a lot more research, at this point CBT is the psychotherapy of choice for BDD. What we know so far indicates that it is often very effective for people with BDD, and it has the advantage of teaching helpful skills that can be used whenever they’re needed.

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COGNITIVE-BEHAVIORAL THERAPY FOR BDD: NEEDED THERAPY RESEARCHCBT is clearly a very promising treatment for BDD. Nonetheless, we need much more research on this treatment! Most important, a CBT treatment manual needs to be developed to guide therapists as they provide CBT. Once a manual is developed and tested, we need more rigorous studies of CBT’s effectiveness using the manual. Studies need to compare CBT to other treatments, such as other types of therapy and SRIs.Research is also needed to determine the optimal session length and number of therapy sessions (although these may vary somewhat for different people). Future studies need to include broader samples of patients (e.g., men as well as women, members of minority groups, people with delusional BDD, and a range of BDD severity). A broader range of outcomes needs to be assessed—not only improvement in BDD but also in body image, functioning, and quality of life.There are many other unanswered questions about CBT that research is needed to answer. Is individual therapy better than group therapy—or vice versa? Each may have its advantages. For example, group therapy enables people to meet others with BDD and involves a lot of exposure (sitting in a room with other people), whereas individual treatment can be better tailored to the individual person. Does CBT help protect against relapse in people who discontinue an effective SRI? Until studies of this important question are done, it shouldn’t be assumed that if you have CBT you’ll do fine if you stop an SRI, although it’s possible that CBT will diminish the risk of relapse. It also needs to be determined whether adding an SRI to partially effective or ineffective CBT makes people even better; clinical experience suggest that it often does. We also need to study for whom CBT works best. In addition CBT needs to be adapted for use in adolescents, since this is the age when BDD usually develops.Even though we need a lot more research, at this point CBT is the psychotherapy of choice for BDD. What we know so far indicates that it is often very effective for people with BDD, and it has the advantage of teaching helpful skills that can be used whenever they’re needed.*332\204\8*

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